TY - JOUR T1 - SARS-CoV-2 lineage B.1.1.7 is associated with greater disease severity among hospitalised women but not men: multicentre cohort study JF - BMJ Open Respiratory Research JO - BMJ Open Resp Res DO - 10.1136/bmjresp-2021-001029 VL - 8 IS - 1 SP - e001029 AU - Oliver Stirrup AU - Florencia Boshier AU - Cristina Venturini AU - José Afonso Guerra-Assunção AU - Adela Alcolea-Medina AU - Angela Beckett AU - Themoula Charalampous AU - Ana da Silva Filipe AU - Sharon Glaysher AU - Tabassum Khan AU - Raghavendran Kulasegaran Shylini AU - Beatrix Kele AU - Irene Monahan AU - Guy Mollett AU - Matthew Parker AU - Emanuela Pelosi AU - Paul Randell AU - Sunando Roy AU - Joshua Taylor AU - Sophie Weller AU - Eleri Wilson-Davies AU - Phillip Wade AU - Rachel Williams AU - The COG-UK-HOCI Variant substudy consortium AU - The COVID-19 Genomics UK (COG-UK) consortium AU - Andrew Copas AU - Maria-Teresa Cutino-Moguel AU - Nick Freemantle AU - Andrew C Hayward AU - Alison Holmes AU - Joseph Hughes AU - Tabitha Mahungu AU - Gaia Nebbia AU - David Partridge AU - Cassie Pope AU - James Price AU - Samuel Robson AU - Kordo Saeed AU - Thushan de Silva AU - Luke Snell AU - Emma Thomson AU - Adam A Witney AU - Judith Breuer Y1 - 2021/09/01 UR - http://bmjopenrespres.bmj.com/content/8/1/e001029.abstract N2 - Background SARS-CoV-2 lineage B.1.1.7 has been associated with an increased rate of transmission and disease severity among subjects testing positive in the community. Its impact on hospitalised patients is less well documented.Methods We collected viral sequences and clinical data of patients admitted with SARS-CoV-2 and hospital-onset COVID-19 infections (HOCIs), sampled 16 November 2020 to 10 January 2021, from eight hospitals participating in the COG-UK-HOCI study. Associations between the variant and the outcomes of all-cause mortality and intensive therapy unit (ITU) admission were evaluated using mixed effects Cox models adjusted by age, sex, comorbidities, care home residence, pregnancy and ethnicity.Findings Sequences were obtained from 2341 inpatients (HOCI cases=786) and analysis of clinical outcomes was carried out in 2147 inpatients with all data available. The HR for mortality of B.1.1.7 compared with other lineages was 1.01 (95% CI 0.79 to 1.28, p=0.94) and for ITU admission was 1.01 (95% CI 0.75 to 1.37, p=0.96). Analysis of sex-specific effects of B.1.1.7 identified increased risk of mortality (HR 1.30, 95% CI 0.95 to 1.78, p=0.096) and ITU admission (HR 1.82, 95% CI 1.15 to 2.90, p=0.011) in females infected with the variant but not males (mortality HR 0.82, 95% CI 0.61 to 1.10, p=0.177; ITU HR 0.74, 95% CI 0.52 to 1.04, p=0.086).Interpretation In common with smaller studies of patients hospitalised with SARS-CoV-2, we did not find an overall increase in mortality or ITU admission associated with B.1.1.7 compared with other lineages. However, women with B.1.1.7 may be at an increased risk of admission to intensive care and at modestly increased risk of mortality.The sequence data analysed are included within publicly available datasets (https://www.cogconsortium.uk/data/). However, due to data governance restrictions it is not possible to share the associated patient characteristics and clinical outcome data for the analysis described, as these are considered sensitive and full anonymisation is not possible. The corresponding author (OTS) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained. ER -